Baby breathing while feeding
Laryngomalacia (for Parents) - Nemours KidsHealth
What Is Laryngomalacia?
Laryngomalacia is a common cause of noisy breathing in infants. It happens when a baby's larynx (or voice box) is soft and floppy. When the baby takes a breath, the part of the larynx above the vocal cords falls in and temporarily blocks the baby's airway.
Laryngomalacia (luh-ring-oh-muh-LAY-shuh) usually gets better on its own by the time a baby is 1 year old.
What Are the Signs & Symptoms of Laryngomalacia?
Babies with laryngomalacia make a harsh, squeaky sound when breathing in. This sound, called stridor, can start as soon as the baby is born or, more often, in the first few weeks after birth. Symptoms usually get worse over several months.
Most babies with laryngomalacia do not have trouble breathing or feeding, even though their breathing is noisy. Breathing usually gets noisier when the baby is crying, feeding, sleeping, lying down, or has an upper respiratory infection.
Most babies with the condition have mild symptoms. A baby whose symptoms are more serious might have:
- trouble breathing (look for tugging in at neck or stomach)
- feeding problems
- poor weight gain
- breathing pauses (apnea)
- blue skin or lip color (cyanosis)
Call the doctor right away if your baby has these symptoms or breathing suddenly gets worse.
Babies with laryngomalacia often have gastroesophageal reflux (GER). This happens when food and acid go back up into the esophagus. If stomach acid reaches the voice box, symptoms may get worse. Formulas or medicines to help with reflux may help with breathing symptoms.
What Causes Laryngomalacia?
Doctors don't know what causes laryngomalacia, but it may have something to do with how the voice box formed before the baby was born. The muscles supporting the voice box may be weak or don't coordinate well with breathing. Gastroesophageal reflux may also play a role.
How Is Laryngomalacia Diagnosed?
Doctors often suspect laryngomalacia at birth or soon after based on the baby's symptoms and an exam. To confirm the diagnosis, a pediatric ear, nose, and throat (ENT) specialist will do a procedure called flexible laryngoscopy. To do this, the doctor passes a thin tube through the baby's nose or mouth to look at the airway and vocal cords in the voice box.
The doctor may check oxygen levels and order other tests to check for swallowing problems or GER. The baby's good weight gain and growth are very important.
How Is Laryngomalacia Treated?
Most of the time, laryngomalacia gets better on its own, usually by a baby's first birthday. Doctors will do regular exams to check the baby's breathing and weight. Because most babies also have GER, doctors usually prescribe anti-reflux medicine.
A baby who has severe breathing problems or poor growth may need a surgery called supraglottoplasty (soo-pruh-GLOT-oh-plass-tee). Doctors do this procedure through the baby's mouth to tighten the floppy tissue above the voice box. This will improve the baby's feeding and breathing.
What Else Should I Know?
Noisy breathing and other laryngomalacia symptoms usually get worse over several months, then start to improve after 3–6 months. Symptoms clear up completely in most kids. Occasionally, an older child with a history of laryngomalacia may have noisy breathing while exercising, during a viral infection, or when sleeping.
Reviewed by: Steven M. Andreoli, MD
Date reviewed: October 2019
What’s Typical and When You Should See a Doctor
Newborns often make unusual noises while breathing. Most of them are no cause for concern. But being aware of your baby’s typical breathing pattern can help you identify any concerns early.
Newborns often have irregular breathing patterns that concern new parents. They can breathe fast, take long pauses between breaths, and make unusual noises.
Newborns’ breathing looks and sounds different from adults because:
- They breathe more through their nostrils than their mouth.
- Their breathing pathways are much smaller and easier to obstruct.
- Their chest wall is more pliable than an adult’s because it’s made of mostly cartilage.
- Their respiration isn’t fully developed since they still have to learn to use their lungs and the associated breathing muscles.
- They may still have amniotic fluid and meconium in their airways right after birth.
Usually, there’s nothing to worry about, but parents and caregivers may worry anyway.
One thing you can do is to pay careful attention to your newborn’s typical breathing pattern. This way you can learn what’s usual for them — so you’ll be able to tell if something is different later.
Typically, a newborn takes 30 to 60 breaths per minute. This can slow down to 30 to 40 breaths per minute while they sleep. At 6 months, babies breathe about 25 to 40 times per minute. An adult, meanwhile, takes about 12 to 20 breaths per minute.
Newborns can also take rapid breaths, then pause for up to 10 seconds at a time. All of this is very different from adult breathing patterns, which is why new parents might be alarmed.
Within a few months, most of the irregularities of newborn breathing resolve themselves.
Some newborn breathing concerns are more common in the first few days, such as transient tachypnea. But after 6 months, most breathing concerns are probably due to allergies or a short-term illness like the common cold.
It’s important that you become familiar with your baby’s typical breathing sounds and patterns. If something sounds different, listen carefully so you can explain what’s different to your pediatrician.
Respiratory distress is one of the most common causes of neonatal intensive care hospital admittance, according to 2020 research.
The following are common sounds you might hear and their potential causes.
This might be a blockage in the nostrils that will clear when it’s suctioned (removed). Ask your pediatrician how to gently and effectively suction mucus.
Hoarse cry and barking cough
This noise may be from a windpipe blockage. It might be mucus or inflammation in the voice box, such as croup. It can be a sign of croup, in which case it may get worse at night.
This is likely a blockage in large bronchi. Large bronchi are tubes that carry air between the windpipe and lungs. A doctor will need to listen with a stethoscope to confirm this diagnosis.
Wheezing can be a sign of blockage or narrowing of the lower airways. The blockage might be caused by:
- respiratory syncytial virus
This can mean there’s fluid in the airways from an infection, such as pneumonia. Fast breathing can also be caused by fever or other infections and should be evaluated right away.
This is usually due to mucus in the nostrils. In rare cases, snoring can be a sign of a chronic condition, such as sleep apnea or enlarged tonsils.
Stridor is a constant, high-pitched sound that indicates airway obstruction, according to 2021 research. It can sometimes be caused by laryngomalacia.
A sudden, low-pitched noise on an exhale usually signals an issue with one or both lungs. It can also be a sign of severe infection. You should visit a doctor immediately if your baby is ill and is grunting while breathing.
Sneezing is common in newborns and is not usually cause for concern.
This is because newborns have smaller nasal passages than adults and are still adjusting to breathing through their noses as they grow and develop.
If sneezing is accompanied by other symptoms like coughing, difficulty breathing, or a fever, you should talk with a doctor. It could be a sign of a respiratory infection, according to 2021 research.
Frequent sneezing can also be a sign of an allergy to certain types of formula as well as neonatal abstinence syndrome. Per 2020 research, neonatal abstinence syndrome occurs when babies are exposed to opioid drugs before birth.
Periodic breathing is common in newborns. It is characterized by pauses in breathing that lasts at least 3 seconds, followed by clusters of breaths, which are often fast and shallow.
This is typical and doesn’t usually require any treatment. However, if pauses in breathing last more than 20 seconds, it may indicate a problem such as infant apnea.
False “first cold”
Many newborns seem to experience symptoms of a false first cold very early, which occurs because their nasal passages are very small and can become easily clogged.
Though this doesn’t usually require any treatment, you may consider talking with a pediatrician about ways to help improve their breathing if needed, such as using saline drops or a nasal aspirator.
If your baby is also experiencing other cold symptoms like irritability, decreased appetite, or difficulty sleeping, it’s best to talk with a doctor to address any concerns and determine whether they may have a cold or other infection.
Hiccups are common and can happen in babies, children, and adults.
Eating too quickly and swallowing air while feeding are two of the possible causes of hiccups in newborns.
Hiccups may also be a symptom of gastroesophageal reflux, which occurs when the contents of the stomach flow into the esophagus, causing regurgitation.
Never hesitate to reach out to your doctor if you’re concerned about your baby’s breathing.
Irregular breathing can be very alarming and may cause anxiety in parents or caregivers. But first, slow down and look at your baby to see whether they look like they’re in distress.
Here are some tips if you’re concerned about your baby’s breathing:
- Learn your child’s typical breathing patterns so you’re better prepared to identify what’s not typical.
- Take a video of your baby’s breathing and show it to a doctor. Many medical professionals now offer online appointments or communication by email, saving you a possibly unnecessary trip to the office.
- Always have your baby sleep on their back. This decreases your baby’s risk of sudden infant death syndrome (SIDS), per 2021 research. If your baby has a respiratory infection and isn’t sleeping well, ask your doctor for safe ways to help clear congestion. It’s not safe to prop them up or put their crib on an incline.
- Saline drops, sold over the counter at drugstores, can help loosen thick mucus.
- Sometimes, babies breathe fast when they’re overheated or upset. Clothe your baby in breathable fabrics. You should only add one extra layer more than what you yourself are wearing for the weather that day. So, if you’re wearing pants and a shirt, your baby might wear pants, a shirt, and a sweater.
Sleep positioners and wedges are not recommended while feeding or sleeping.
These padded risers are intended to keep your baby’s head and body in one position but are not recommended by the Food and Drug Administration due to the risk of SIDS.
Catching an issue early gives your baby the best chance for recovery in the short term and decreases future concerns.
A change in a newborn’s breathing pattern may indicate a serious breathing problem. If you’re ever concerned, call your doctor right away. Memorize the doctor’s after-hours phone numbers or have them available at all times. Most offices have a nurse on call that can answer and help direct you.
Doctors may use a chest X-ray to diagnose breathing concerns and make a treatment plan.
If your child experiences any of these symptoms, call 911 or your local emergency services:
- blue color in lips, tongue, fingernails, and toenails
- doesn’t breathe for 20 seconds or more
See your doctor immediately if your child:
- is grunting or moaning at the end of each breath
- has nostrils flaring, which means they’re working harder to get oxygen into their lungs
- has muscles pulling in on the neck, around collarbones, or ribs
- has difficulty feeding in addition to breathing issues
- is lethargic in addition to breathing issues
- has a fever as well as breathing issues
Babies tend to breathe faster than older kids and adults. Sometimes they make unusual noises. Rarely, infants may have trouble breathing because of a serious health concern.
It’s important that you can tell right away if your baby is having trouble breathing. Familiarize yourself with your baby’s usual breathing patterns and get help right away if something seems wrong.
The baby gets tired quickly when feeding and breathes often: symptoms, diagnosis
With the advent of the baby, all the mother's attention is focused on feeding the baby. After all, I really want the baby to gain weight well. But often during feeding, a woman notices that the baby gets tired quickly. In such a situation, the baby's breathing quickens, which prevents him from eating the prescribed norm. If such a picture is observed with frightening frequency, it is necessary to find out the cause of the problem.
In pediatric cardiology, there are several important signs that indicate heart problems in a young patient. The children's cardiologist of the multidisciplinary center "Edkarik" will be able to figure out what caused the difficulties in feeding. At the first negative symptoms in the baby, parents should contact us to exclude the presence of a serious heart pathology in the crumbs.
Features of breathing in infants
It should be noted right away that difficulty breathing during feeding is not always an indicator of an existing heart pathology. Such a symptom is typical for respiratory diseases, breathing difficulties may be associated with structural features of the nasal septum. This problem is often observed in the first weeks due to undeveloped breasts in the mother. The child has to make every effort to get the right portion of food. Therefore, he quickly gets tired, and his breathing goes astray from the normal rhythm.
The breathing of children in the first months of life has its own characteristics. Babies need twice the amount of oxygen, but their respiratory system is not yet completely formed. Certain difficulties in the respiratory function are imposed by narrow nasal passages and weakness of the pectoral muscles. Therefore, breathing in children up to a year is uneven. The child often takes quick breaths, so his breathing is shallow and intermittent.
The norm of respiratory movements in babies of the first month of life is 40-60, from the end of the fourth week and up to 3 months - up to 45, in the period of 4-6 months - 35-40. By the year, the baby is already taking about 30-35 breaths per minute, which is considered the norm.
Mom can determine the respiratory rate on her own. To do this, put the baby on his back, and use a stopwatch to count the number of breaths. Since babies "breathe" with their tummies, such a calculation is easy to make. The main condition for performing this procedure is that the child must be calm.
When there is no reason to worry
The nervous system of young children is still imperfect, so they cannot control their breathing. During active games and crying, the frequency of respiratory movements increases, and in a dream they often sniffle. If such features are observed sporadically, you should not worry. The sniffing nose can be washed with boiled water, and then carefully remove the dried mucus.
What should cause alarm
You need to see a doctor if the baby:
- holds his breath for a long time;
- exhales noisily;
- if breathing is accompanied by wheezing and wheezing.
Typically, such symptoms can be traced against the background of an acute period of respiratory diseases. Timely treatment will help to quickly eliminate these negative signs, after which the child will be able to breastfeed normally again.
Which symptoms require special attention
We have listed physiological breathing problems. But sometimes the situation is much more serious than the usual runny nose. We list the signs that should be a strong argument for parents to urgently visit a pediatric cardiologist.
If holding the breath during feeding is accompanied by a blue nasolabial triangle, this sign indicates a lack of oxygen. In severe forms of cardiac pathologies, the chin and fingers of the baby turn blue. This symptom is characteristic of congenital malformations of both the heart and vascular anomalies.
- Shortness of breath
This symptom also indicates a lack of oxygen. Since the child has to expend more energy during sucking, this symptom is more pronounced than at rest. A cause for concern can be considered frequent breaks for rest during suckling. Normally, there are no more than two such pauses, and a child with heart disease takes breaks after 2-3 sips.
Infants with congenital heart defects are much less active than healthy children. They are not able to suck out the norm during feeding, so they lose weight. The problem is aggravated by frequent breathing. The child simply suffocates under tension.
- Chest pain
Infants may not complain of such a symptom, but an observant mother will notice under what circumstances and how often the child begins to worry.
If all the described signs are repeated from the baby during feeding regularly, it is urgent to consult a pediatric cardiologist. A full-scale examination will determine the cause of the problem, and an experienced pediatric cardiologist will prescribe adequate therapy for the child.
Peculiarities of diagnosing infants
Babies under one year old cannot describe the symptoms that prevent them from developing normally. Therefore, all hope for an objective examination. During the initial examination of the infant, a pediatric cardiologist:
- evaluates the general condition;
- notes the color of the skin;
- listens to the baby's heart;
- performs heart rate monitoring and saturation level measurement.
The doctor pays special attention to taking an anamnesis, since such information can indicate the cause of the problem. For example, an infection transmitted by a woman during her mother's pregnancy can provoke the development of congenital heart defects. An important factor is heredity, especially if there were cases of premature death (up to 50 years) among close relatives in the family. After collecting the data, the pediatric cardiologist will definitely prescribe the following types of diagnostic procedures:
- ECG with daily monitoring;
- ultrasound of the heart;
- Chest x-ray;
- Laboratory tests.
Instrumental methods of examination with the use of modern devices will clarify the parameters of the baby's heart and the features of its anatomical structure. Ultrasound diagnostics helps to identify defects in the heart chambers and great vessels. Having the data of all studies at hand, the pediatric cardiologist will draw up an individual treatment program, or prescribe additional procedures. In severe cardiac pathologies and rhythm disturbances, the question of a surgical way to eliminate the problem can be decided.
Examination and treatment in the center "Edkarik"
Among our guarantees:
- professionalism of doctors;
- high quality service;
- comfortable conditions in the clinic;
- individual approach;
- a wide range of services;
- accompanying patients during the rehabilitation period.
Our clinic is known not only in Kaliningrad, but also in other regions of the country. Parents and their kids will feel comfortable in our center, because there is everything you need to make sick children feel at home with us. You can make an appointment with a pediatric cardiologist on the official website of our center. There are also contact numbers where parents can consult on issues of concern to them.
Breathe to eat?!
The topic of breastfeeding is very relevant both for those who are just preparing to become a mother, and for those who are already clutching their first child to their breasts. Mother's milk is truly the best food that can only be offered to a child up to a year old. It helps the baby grow healthy and strengthens his immunity. That is why it is especially necessary for a child in the first six months of life. Breast milk contains all the necessary nutrients for the baby, and in the optimal ratio and form, adapted to the characteristics of the digestive system of the newborn. In addition, it is rich in vitamins, enzymes, minerals and contributes to the creation of the necessary conditions for the formation of the "correct" intestinal microbial biocenosis.
In addition, during breastfeeding there is direct communication between mother and child, which contributes to the formation of a positive emotional bond between them. The very act of sucking is extremely important for the baby. Sucking for an infant is a need and a pleasure that is not directly related to the feeling of hunger. Thanks to sucking, the baby develops the jaw apparatus, muscles of the mouth and tongue, which is especially important in the future, for example, in the development of speech.
But sometimes the process of feeding may not go as smoothly as a mother would like. One of the most common reasons a baby refuses to breastfeed is difficulty in breathing through the nose. A significant role in the development of this condition is given to the physiological characteristics of the nasal mucosa of the newborn, as well as the anatomical features of the child's nose. In an infant, the nasal passages are much wider and shorter, the mucous lining the nasal cavity is thickened and rich in a dense network of blood vessels, while the number of glands that produce mucus is not yet large. Even a small swelling of the mucosa can block nasal breathing. During breastfeeding, the baby has to suck and breathe at the same time, and if the nose is clogged, it is simply impossible to combine these processes. If the baby does not breathe through the nose, feeding turns into torment - the baby cannot suckle without interruption, because he is suffocating.
The child constantly has to let go of the chest in order to breathe in air through the mouth. This is repeated several times, and as a result, the baby drops the breast. In addition, swallowing air through the mouth contributes to its entry into the stomach, followed by regurgitation of its contents. Frequent regurgitation, in turn, contributes to irritation of the nasal mucosa and nasopharynx with gastric contents and the development of inflammation - rhinitis, which is manifested by prolonged difficulty in nasal breathing.
That is why it is so important for newborns to pay close attention to nasal hygiene to ensure and maintain free nasal breathing. On the Internet, you can find recommendations advising mothers to instill vasoconstrictors for babies in the nose of babies before feeding. Such advice can be useful only if the child has a runny nose, in all other cases, one should be aware of side effects and the inadmissibility of long-term use of such drugs, as well as the need to consult a doctor.
For daily care and cleansing of the nasal mucosa, special products based on natural sea water have been developed. One of these products is the RINOSTOP® AQUA product line.
RINOSTOP® AQUA contains 100% natural sea water, widely known for its beneficial properties. No preservatives, stabilizers or other chemicals that can cause irritation of the nasal mucosa are used in the process of production and purification of water; preserved macro- and microelements of natural sea water (K, Mg, Na, Ca, Cl).
The products of the line are available in bottles of different sizes; equipped with nozzles that take into account the anatomical structure of the nose and provide a continuous spray of water of different intensity - in the form of a jet, shower or soft shower.
The special design of the "BAG-ON-VALVE" bottles allows the use of funds in any position of the bottles with a full consumption of the contents without residue.
RINOSTOP® AQUA BABY is perfect for daily hygiene and moisturizing of little noses from birth. It contains sea water in an isotonic concentration close in its physiological characteristics to human plasma. Micro-diffusion water supply in the form of a soft shower provides:
- gentle care for the delicate nasal mucosa of babies;
- uniform irrigation of the entire surface of the mucosa by spraying sea water in the form of tiny particles mixed with air - "water vapor"; it is this spray that minimizes the risk of getting into the middle ear cavity;
- cleansing of mucus, crusts, dust and small foreign particles;
- maintaining the normal physiological state of the nasal mucosa and facilitating nasal breathing in babies, contributing to the normalization of good sleep and optimizing the process of breastfeeding;
- moisturizing the nasal mucosa of infants, incl.